| Organization Name: | STATE OF WYOMING |
| NPI Number: | 1023154564 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN KULOW (OPERATIONS MGR) |
| Mailing Address: | 8204 State Highway 789 Lander |
| State: | WY US |
| Postal Code: | 825202941 |
| Phone Number: | 3073356719 |
| Fax Number: | 3073356987 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 12/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336I0012X |
| License Number: | 5202926IP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Institutional Pharmacy |
| Taxonomy Definition: | A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |